Evaluation of clinical manifestations of infants 2 to 18 months with the possibility of allergy to cow's milk protein referred to the gastrointestinal clinic and common methods of treatment and response to treatment

Document Type : Research Paper

Authors

1 Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

2 Assistant Professor of Pediatrics Gastroenterology Department of Pediatrics, School of Medicine Ayatollah Mousavi Hospital Zanjan University of Medical Sciences, Zanjan, Iran

3 Student Research Committee, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran

Abstract

Background:
Allergy to cow's protein without treatment can cause problems such as insufficient growth in height and weight of children. The present study was conducted with the aim of comparing 4 types of treatment regimens in cow's milk protein sensitivity.
Method:
In this cross-sectional study, a total number of 50 infants with cow's milk feeding syndrome who referred to the pediatric clinic were selected. The rate of response to therapeutic regimens, including the elimination of dairy from the mother's diet, semi-hydrolyzed formula, fully hydrolyzed formula, and the amino acid-based formula was evaluated in children. The tool for compiling a checklist was prepared based on the literature review and under the supervision of a specialist in pediatrics. The analysis was done in spss19 software.
Results:
In this study, the most common findings of visiting a doctor were 31 (68 %) gastrointestinal bleeding, and 14 (28 %) dermatitis. The rate of response to different treatments was 6 (12%), semi-hydrolyzed formula 2 (4%), fully hydrolyzed formula 8 (14%), and formula based on amino acids 34 (68%), respectively, to remove dairy products from the mother's diet.
Conclusion:
The most common finding in infants with cow's milk protein allergy referred to a pediatric gastroenterology clinic was gastrointestinal bleeding, and the best treatment responses were to the formula based on amino acids.

Keywords

Main Subjects

References

  1. Oriel RC, Wang J. Diagnosis and management of food allergy. Immunology and Allergy Clinics. 2021 Nov 1;41(4):571-85. https://doi.org/10.1016/j.iac.2021.07.012
  2. Jaiswal L, Worku M. Recent perspective on cow’s milk allergy and dairy nutrition. Critical Reviews in Food Science and Nutrition. 2022 Sep 22;62(27):7503-17
  3. Luyt D, Ball H, Makwana N, Green MR, Bravin K, Nasser SM, et al. BSACI guideline for the diagnosis and management of cow’s milk allergy. Clin Exp Allergy. 2014;44(5):642–72.  
  4. Ahrens B, Lopes de Oliveira LC, Grabenhenrich L, Schulz G, Niggemann B, Wahn U, et al. Individual cow’s milk allergens as prognostic markers for tolerance development? Clin Exp Allergy. 2012 Nov;42(11):1630–7.  
  5. Yuan M. Timing of infant formula introduction and risk of atopic diseases and being overweight during early childhood. 2021 Jul 21
  6. Dominguez-Ortega G, Borrelli O, Meyer R, Dziubak R, De Koker C, Godwin H, Fleming C, Thapar N, Elawad M, Kiparissi F, Fox AT. Extraintestinal manifestations in children with gastrointestinal food allergy. Journal of pediatric gastroenterology and nutrition. 2014 Aug 1;59(2):210-4.
  7. Santos A, Dias A, Pinheiro JA. Predictive factors for the persistence of cow’s milk allergy. Pediatr Allergy Immunol. 2010 Dec;21(8):1127–34.  
  8. Wood R, Sicherer S, Vickery B, … SJ-J of allergy and, 2013  undefined. The natural history of milk allergy in an observational cohort. Elsevier [Internet]. [cited 2022 Oct 18]; Available from: https://www.sciencedirect.com/science/article/pii/S0091674912018593?casa_token=SfwinZhmjQ4AAAAA:CAKsVZAbzxDgJ2LKycv0UCJ3UIJSFKVCgL0iQ2JzFhi3gBg-EOkuAK-ez96XfRXzu1zzgxvJVAwg https://doi.org/10.1016/j.jaci.2012.10.060
  9. 9.             Flom JD, Sicherer SH. Epidemiology of cow’s milk allergy. Nutrients. 2019;11(5):1051.
  10. 10.          Shamir R, Agostoni C, Axelsson I, Goulet O, Koletzko B, Fleischer Michaelsen K, et al. Soy protein infant formulae and follow-on formulae: a commentary by the ESPGHAN Committee on Nutrition. journals.lww.com [Internet]. 2006 [cited 2022 Oct 18];42. Available from: https://journals.lww.com/jpgn/Fulltext/2006/04000/Editorials.00003.aspx
  11. 11.          Salvatore S, Agosti M, Baldassarre ME, D’Auria E, Pensabene L, Nosetti L, et al. Cow’s Milk Allergy or Gastroesophageal Reflux Disease—Can We Solve the Dilemma in Infants? Nutrients. 2021;13(2):297.
  12. 12.          V LZ, R NR, … LMP-R colombiana, 2018  undefined. Outcomes of treating infants with cow’s milk protein allergies with an extensively hydrolyzed serum-based formula. scielo.org.co [Internet]. [cited 2022 Oct 18]; Available from: http://www.scielo.org.co/scielo.php?pid=S0120-99572018000200111&script=sci_arttext&tlng=enhttps://doi.org/10.22516/25007440.253 
  13. 13.          Canani R, Nocerino R, … TF-J of P, 2017  undefined. Amino Acid–based Formula in Cow’s Milk Allergy: Long-term Effects on Body Growth and Protein Metabolism. journals.lww.com [Internet]. [cited 2022 Oct 18]; Available from: https://journals.lww.com/jpgn/FullText/2017/04000/Amino_Acid_based_Formula_in_Cow_s_Milk_Allergy_.32.aspx
  14. Kouwenhoven S, Antl N, … MF-… AJ of, 2020  undefined. A modified low-protein infant formula supports adequate growth in healthy, term infants: a randomized, double-blind, equivalence trial. academic.oup.com [Internet]. [cited 2022 Oct 18]; Available from: https://academic.oup.com/ajcn/article-abstract/111/5/962/5685398 https://doi.org/10.1093/ajcn/nqz308
  15. Inuo C, Tanaka K, … YN-AP journal, 2019  undefined. Tolerability of partially and extensively hydrolysed milk formulas in children with cow’s milk allergy. search.informit.org [Internet]. [cited 2022 Oct 18]; Available from: https://search.informit.org/doi/abs/10.3316/ielapa.264388933999186
  16. Nedkova-Milanova V, … DN-J of the U, 2017  undefined. Diagnostic approach and management of cows milk protein allergy in infants. journals.mu-varna.bg [Internet]. [cited 2022 Oct 18]; Available from: https://journals.mu-varna.bg/index.php/isuvsme/article/view/5519 DOI: http://dx.doi.org/10.14748/isuvsme.v22i2.5519
  17. Pensabene L, Salvatore S, D’auria E, Parisi F, Concolino D, Borrelli O, et al. Cow’s Milk Protein Allergy in Infancy: A Risk Factor for Functional Gastrointestinal Disorders in Children? Nutr 2018, Vol 10, Page 1716 [Internet]. 2018 Nov 9 [cited 2022 Oct 18];10(11):1716. Available from: https://www.mdpi.com/2072-6643/10/11/1716/htm https://doi.org/10.3390/nu10111716
  18. Kalach N, Bellaïche M, Elias-Billon I, Dupont C. Family history of atopy in infants with cow’s milk protein allergy: A French population-based study. Arch Pédiatrie. 2019 May 1;26(4):226–31. https://doi.org/10.1016/j.arcped.2019.02.014
  19. Hanan M, She S. COWS’MILK PROTEIN ALLERGY IN INFANTS. dieteticallyspeaking.com [Internet]. [cited 2022 Oct 18]; Available from: https://dieteticallyspeaking.com/wp-content/uploads/2017/09/Issue-127-cows-milk-protein-allergy-in-infants.pdf
  1. D’auria E, Salvatore S, Acunzo M, Peroni D, Pendezza E, Di Profio E, et al. Hydrolysed Formulas in the Management of Cow’s Milk Allergy: New Insights, Pitfalls and Tips. Nutr 2021, Vol 13, Page 2762 [Internet]. 2021 Aug 12 [cited 2022 Oct 18];13(8):2762. Available from: https://www.mdpi.com/2072-6643/13/8/2762/htm ; https://doi.org/10.3390/nu13082762
Medical Journal of Mashhad university of Medical Sciences
Volume 65, Issue 6
January and February 2023
Pages 2268-2272

Files

Share

How to cite

Statistics