Cow's milk allergy versus cow milk intolerance

Area of Science:

• Clinical immunology
• Gastroenterology
• Pediatrics

Background:

• Cow's milk allergy (CMA) and cow's milk intolerance (CMI) are frequently confused terms in clinical practice and research.
• This ambiguity hinders accurate diagnosis and appropriate management of adverse reactions to cow's milk.

Purpose of the Study:

• To clarify the distinct definitions and characteristics of CMA and CMI.
• To promote precise terminology for improved clinical and research outcomes.

Main Methods:

• Literature review focusing on clinical and laboratory findings differentiating CMA and CMI.
• Integration of author's clinical experience to supplement research findings.

Main Results:

• Cow's milk allergy (CMA) is an immune-mediated reaction to cow's milk proteins, affecting various systems and occurring in 1-3% of the population, primarily infants.
• Cow's milk intolerance (CMI) encompasses non-immunologic reactions, most commonly lactase deficiency, prevalent in adults and certain racial groups, causing gastrointestinal symptoms.
• While CMA can be severe, dietary elimination offers a good prognosis; CMI is generally benign but chronic, manageable by reducing cow's milk intake or using lactase supplements.

Conclusions:

• Adverse reactions to cow's milk (CM) must be classified as either immunologic (CMA) or non-immunologic (CMI).
• CMI is a broad category encompassing various conditions that require further specific differentiation for effective management.