Cow's Milk Protein Allergy

Area of Science:

• Allergy and Immunology
• Pediatrics
• Gastroenterology

Background:

• Cow's milk allergy (CMA) is a prevalent food allergy in infants, affecting 0.5% to 3%.
• Reactions can be IgE-mediated, non-IgE-mediated, or mixed, presenting diverse symptoms.
• Gastrointestinal issues like enteropathy and reflux are common, particularly in non-IgE CMA.

Purpose of the Study:

• To provide a comprehensive overview of cow's milk allergy.
• To discuss diagnostic approaches and management strategies.
• To highlight current understanding of prevention and emerging treatments.

Main Methods:

• Review of existing literature on cow's milk allergy diagnosis and management.
• Discussion of diagnostic tools including oral challenges and immunological tests.
• Analysis of therapeutic interventions such as elimination diets and specialized formulas.

Main Results:

• The double-blind placebo-controlled oral challenge is the gold standard for diagnosis.
• Elimination diets followed by supervised challenges are common diagnostic practices.
• Allergen elimination leads to symptom resolution; extensively hydrolyzed or amino acid formulas are recommended substitutes.

Conclusions:

• Cow's milk allergy requires careful diagnosis and management, primarily through allergen avoidance.
• Tolerance develops over time, necessitating periodic reintroduction attempts.
• Oral immunotherapy is an emerging treatment for IgE-mediated CMA, while breastfeeding and timely complementary feeding may aid prevention.