Cow’s Milk Allergy: Management And Prevention

Abstract

Cow’s milk allergy (CMA) is one of the most frequent food allergies in childhood with an estimated prevalence of 2% in infants. As observed in the natural course of this disease, CMA has a good prognosis and more than half of the children reach the tolerance before school age. Otherwise, many different factors can modulate the natural history of CMA. Clinical and laboratory data suggest that many endotypes and phenotypes can be individuated with different evolutions towards tolerance. For these reasons physicians need to identify these different patterns to better choose the therapeutic pathway for each patient. Another aspect is represented by the developing strategies of primary prevention of CMA, such as dietary interventions both in the mother (during pregnancy and/ or lactation), and, in absence of breast milk, also in high risk infants, through the use of extensive or partial hydrolyzed milk formula. Nevertheless many studies have been carried out, up today the available data are still conflicting and more robust results should be reported. The aim of this review article is to give practical advices in the diagnosis, management and prevention of CMA in childhood, according to the most recent guidelines and consensus documents. Corresponding author: Ricci, G. Department of Medical and Surgical Sciences, Pediatric Unit, S. Orsola-Malpighi Hospital, University of Bologna, Massarenti, Bologna, Italy. Tel : +390516363075; Fax : +390516363075; E-mail: giampaolo.ricci@unibo.it Received Date: Dec 13, 2014 Accepted Date: Aug 11, 2015 Published Date: Aug 14, 2015 Int J Food Nutr Sci | Volume 2: Issue 3 Introduction The aim of this paper is to give some synthetic and practical advices in the management of cow’s milk allergy (CMA) in children after a complete and extensive revision of the different items involving this disease reported in the most recent guidelines and consensus documents. Moreover some new data published just in these days on prevention will be described in summary. Epidemiology CMA is one of the most frequent food allergies (FA) in infants and children; its prevalence varies according to different studies, since there are conflicting data between symptoms reported by patients and the diagnosis of FA made through an oral food challenge (OFC). Moreover, the frequencies of FA varies in the different age groups, but overall is also different according to the assessment methods used. The pooled age-stratified prevalence of CMA has been recently reviewed and reported in the guidelines of the European Academy of Allergy and Clinical Immunology (EAACI)[1]. These data are summarized in Table 1, according to the different assessment methods: self-reported diagnosis, presence of specific IgE (sIgE) against CMA, presence of a positive skin prick test (SPT) and response of OFC. Anyway, these data show that the prevalence of CMA confirmed by an OFC with CMA is about 2% in infants. Cow’s Milk Allergy: Management and Prevention 1 Department of Medical and Surgical Sciences, Pediatric Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy DOI: 10.15436/2377-0619.15.013 Citation: Ricci, G. Cow’s Milk Allergy: Management and Prevention.(2015) J Food Nutr Sci 2(3): 1-6. Copy rights: ©2015 Ricci, G. This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License.