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Cow`s milk protein allergy awareness and practice among Turkish pediatricians: A questionnaire-survey
Aysel Yüce1, Buket Dalgıç2, Fügen Çullu-Çokuğraş3
1Department of Pediatric Gastroenterology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Insights
Turkish pediatricians show high awareness of cow's milk protein allergy (CMPA) symptoms and diagnosis. However, practices regarding treatment, especially for specific infant groups, require improvement to align with guidelines.
Area of Science:
- Pediatrics
- Allergy Immunology
- Clinical Practice Research
Background:
- Cow's milk protein allergy (CMPA) is a common concern in infants.
- Turkey lacks region-specific guidelines for CMPA prevention, diagnosis, and treatment.
- Pediatrician awareness and practice are crucial for effective CMPA management.
Purpose of the Study:
- To assess the awareness and current practices of Turkish pediatricians regarding CMPA.
- To identify gaps in CMPA management among Turkish pediatricians.
Main Methods:
- A cross-sectional questionnaire-survey was conducted.
- 410 Turkish pediatricians voluntarily participated.
- Data collected included demographics, CMPA awareness, and clinical practices.
Main Results:
- High recognition of CMPA symptoms like atopic dermatitis, diarrhea, and blood in stool.
- Majority favored maternal dietary elimination for breastfed infants and amino acid-based formula for others.
- Discrepancies noted in avoiding other mammalian milks and selecting formulas for specific infant categories.
Conclusions:
- Turkish pediatricians demonstrate strong awareness of CMPA clinical presentation and initial diagnostic steps.
- CMPA management practices need enhancement, particularly in formula selection for non-exclusively breastfed and at-risk infants.
- Adherence to guideline-based indications and cost-effectiveness in CMPA treatment is recommended.
Abstract:
Yüce A, Dalgıç B, Çullu-Çokuğraş F, Çokuğraş H, Kansu A, Alptekin-Sarıoğlu A, Şekerel BE. Cow`s milk protein allergy awareness and practice among Turkish pediatricians: A questionnaire-survey. Turk J Pediatr 2017; 59: 233-243. Region-specific recommendations for the prevention, diagnosis, and treatment of cow`s milk protein allergy (CMPA) are not available in Turkey. This cross-sectional questionnaire-survey was designed to evaluate CMPA awareness and practice among Turkish pediatricians. A total of 410 pediatricians were included based on their voluntary participation. Questionnaires elicited demographic data and pediatricians` awareness and practice of CMPA in infants and children. Atopic dermatitis (91.5%), diarrhea (88.0%) and significant blood in stool (85.9%) were the most common symptoms considered suggestive of CMPA. Continuation of breast feeding via elimination of CMP containing products from maternal diet was the most commonly selected (79.0%) therapeutic option in exclusively breast-fed infants diagnosed with CMPA. Amino acid-based formula was the most commonly selected formula in a non-exclusively breast-fed infant with CMPA, for infants presenting with anaphylaxis (58.8%), enterocolitis (40.7%) or multiple food allergies (52.0%), and also for at-risk infants (40.2%). Earliest time to re-challenge was identified to be 6 months by 52.0% of pediatricians. In conclusion, our findings revealed high awareness of CMPA among Turkish pediatricians in terms of clinical presentation and first priority diagnostic tests. However, CMPA practice among Turkish pediatricians needs to be improved in terms of avoidance of other mammalian milks, selection of therapeutic formulas among non-exclusively breast-fed infants and at-risk infants consistent with guideline-based indications and cost-effectivity.