Early identification of cow’s milk protein allergy in infants in Kirkuk, Iraq, using milk-related symptom scores

Abstract

Abstract Background: Milk is related to many gastrointestinal disorders from the cradle to the grave due to the many milk ingredients that can trigger gastrointestinal discomfort and disorders. Cow’s milk protein allergy (CMPA) is the most common food allergy, especially in infancy and childhood, which may persist into adulthood. Objectives: The aim of this study was to evaluate the effect of cow’s milk protein allergy (CMPA) in infants in its early identification using CMPA scoring system. Materials and Methods: We carried out an observational study at Azadi teaching Children’s Hospital’s pediatric gastrointestinal clinic from March to December 2021. Children seen in our pediatric GI clinic between the ages of 1 and 12 months were included. Infants with suspected CMPA were evaluated by cow’s milk-related symptom score (CoMiSS) tool. An allergic reaction, a gastrointestinal, respiratory, or dermatologic presentation, excluding an acute infectious disease, and at least one of the following conditions were required for a diagnosis of suspected CMPA. All participating doctors received the required training on CoMiSS, the oral challenge test procedure, and CMPA diagnosis and treatment guidelines before subject recruitment. Results: In this study, most of studied infants were men, and no significant difference between CMPA and non-CMPA infants regarding sex, age, and weight was found. In this study, 17.85% of infants with CMPA score suffered from occult blood in their fecal samples compared with 11.15% of non-CMPA infants (P < 0.05). In this study, most of infants with CMPA have score 12, and the mean was 13.65 and the maximum value was 18. Conclusions: The CMPA score system provides primary healthcare clinicians with a simple, fast, and easy-to-use awareness tool for cow’s milk-related symptoms.