Cow's milk protein allergy.

Area of Science:

• Pediatric Allergy and Immunology
• Gastroenterology
• Clinical Nutrition

Background:

• Cow's milk protein allergy (CMPA) impacts 2-7.5% of children, with most developing tolerance by age 4.
• CMPA involves IgE or non-IgE mediated immune responses to milk proteins like casein and whey.
• Symptoms can be immediate or delayed, necessitating accurate diagnosis.

Purpose of the Study:

• To outline the diagnostic approaches for CMPA.
• To detail the dietary management strategies for infants and children with CMPA.
• To provide evidence-based recommendations for formula selection in CMPA cases.

Main Methods:

• Diagnosis relies on detailed medical history, skin prick tests, patch tests, laboratory assessments, elimination diets, and oral food challenges.
• Dietary management involves strict elimination of cow's milk protein.
• Nutritional support utilizes extensively hydrolyzed whey or casein formulas, amino acid-based formulas, or soy formulas.

Main Results:

• Extensively hydrolyzed whey or casein formulas are the first-line choice for mild to moderate CMPA.
• Amino acid-based formulas are recommended for severe CMPA or cases unresponsive to hydrolyzed formulas.
• Tolerance development is common, with 51% resolving within 2 years and 80% within 3-4 years.

Conclusions:

• CMPA diagnosis requires a multi-faceted approach combining clinical history and objective testing.
• Appropriate formula selection is crucial for effective CMPA management, with hydrolyzed and amino acid-based options offering distinct benefits.
• Early diagnosis and tailored dietary interventions facilitate tolerance development and improve outcomes for affected children.