[Research progress on cow's milk protein allergy in preterm infant]

Area of Science:

• Neonatology
• Pediatric Allergy
• Gastroenterology

Background:

• Parenteral nutrition is crucial for preterm infant growth.
• Cow's milk protein allergy (CMPA) in preterm infants has low incidence but atypical, easily misdiagnosed symptoms.
• Misdiagnosis of CMPA can negatively impact preterm infant development and prognosis.

Purpose of the Study:

• To review the epidemiology, clinical features, diagnosis, and management of CMPA in preterm infants.
• To highlight diagnostic challenges and current treatment strategies for CMPA in this population.
• To identify the need for further research in early CMPA detection in preterm infants.

Main Methods:

• Review of existing literature on CMPA in preterm infants.
• Analysis of epidemiological data, clinical manifestations, and diagnostic approaches.
• Evaluation of treatment and prevention strategies, emphasizing the avoidance test.

Main Results:

• CMPA onset in preterm infants is typically delayed.
• Common symptoms include bile-like vomiting and necrotizing enterocolitis-like presentations, with rare rectal bleeding.
• Diagnosis primarily relies on clinical observation and avoidance/challenge tests.

Conclusions:

• CMPA diagnosis in preterm infants is challenging due to atypical symptoms.
• Management involves maternal dietary exclusion or hydrolyzed/amino acid-based formulas.
• Early identification of CMPA in preterm infants requires further clinical and basic research.