<scp>BSACI</scp> guideline for the diagnosis and management of cow's milk allergy

Luyt, David; Ball, Heidi; Makwana, Nick; Green, M. R.; Bravin, Kristian; Nasser, Shuaib; Clark, Andrew

doi:10.1111/cea.12302

Cited by 316 publications

(444 citation statements)

References 166 publications

(223 reference statements)

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“…Chronic respiratory symptoms such as asthma are uncommon in food allergy 3,4 . However, acute upper respiratory tract symptoms (rhinitis, nasal congestion) and lower respiratory tract symptoms (wheezing, cough and stridor) are not uncommon and some manifestations are potentially life threatening 3,4 .…”

Section: Respiratory Symptomsmentioning

confidence: 99%

“…CMA is classified based on the underlying immune mechanism based on timing and organ system involved 4 . IgE mediated reactions are more common and occur within minutes or mostly within one hour after ingestion of even a small amount of milk.…”

Section: Introductionmentioning

confidence: 99%

“…IgE mediated reactions are more common and occur within minutes or mostly within one hour after ingestion of even a small amount of milk. These reactions can vary from minor skin rash to life threatening anaphylaxis 4 . Delayed reactions are nonIgE mediated and generally onset is several hours to days following ingestion of a larger volume of milk 3,4 .…”

Section: Introductionmentioning

confidence: 99%

“…These reactions can vary from minor skin rash to life threatening anaphylaxis 4 . Delayed reactions are nonIgE mediated and generally onset is several hours to days following ingestion of a larger volume of milk 3,4 . Table I describes the diversity of presentations of CMA based on the immunological reaction.…”

Section: Introductionmentioning

confidence: 99%

“…Gastrointestinal symptoms: This includes vomiting, diarrhoea, bloody stools, abdominal pain and reflux disease 3,4 .…”

Section: Introductionmentioning

confidence: 99%

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Cow’s milk allergy

Liyanage

2015

Sri Lanka J Child Health

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Section: Respiratory Symptomsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Gastrointestinal symptoms: This includes vomiting, diarrhoea, bloody stools, abdominal pain and reflux disease 3,4 .…”

Section: Introductionmentioning

confidence: 99%

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Cow’s milk allergy

Liyanage

2015

Sri Lanka J Child Health

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Assessment of Evidence About Common Infant Symptoms and Cow’s Milk Allergy

et al. 2020

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Symptoms, such as crying, vomiting, and rashes, during infancy are not new, but in the 21st century, many parents attribute them to an underlying cow's milk allergy (CMA). In this Special Communication article, we explore the evidence for managing common infant symptoms by avoiding cow's milk. Prescriptions of specialized formula products for managing CMA have risen steeply since the turn of the 21st century; for example, data from Australia and England show 10-fold rises in amino acid formula prescriptions between 2000 and 2010 and 2005 and 2018, respectively (Figure 1). 1,2 This increased demand for products used to manage CMA is not matched by evidence of an increase in disease prevalence. Although one small Chinese study 3 suggested that CMA and allergic sensitization to milk in children aged up to 2 years may have increased between 1999 (3.2% sensitized and 1.6% allergic; n = 314) and 2009 (6.2% sensitized and 3.5% allergic; n = 401), 3 this was not supported by a larger Australian study 4 that found no change in allergic sensitization to cow's milk at age 12 months in high-risk infants between 1990 and 1994 (2.4%; 95% CI, 1.6-3.1; n = 541) and 2006 and 2010 (2.6%; 95% CI, 2.0-3.4; n = 1893). Similarly, in the United States, there was no change in allergic sensitization to milk (specific IgE Ն2 kU/L) in children aged 6 to 19 years between National Health and Nutrition Exami-IMPORTANCE Sales of specialized formula for managing cow's milk allergy (CMA) have increased, triggering concern that attribution of common infant symptoms, such as crying, vomiting, and rashes, to CMA may be leading to overdiagnosis, which could undermine breastfeeding.OBJECTIVE To understand whether CMA guideline recommendations might promote CMA overdiagnosis or undermine breastfeeding.EVIDENCE REVIEW We reviewed recommendations made in CMA guidelines and critically appraised 2 key recommendations. First, we reviewed relevant literature summarizing whether maternal or infant dietary exclusion of cow's milk is effective for managing common infant symptoms. Second, we reviewed published data on breastmilk composition and thresholds of reactivity in CMA to estimate the probability that cow's milk protein in human breastmilk can trigger symptoms in infants with CMA. We also documented the level of commercial involvement in CMA guidelines.FINDINGS We reviewed 9 CMA guidelines published from 2012 to 2019. Seven suggest considering CMA as a cause of common infant symptoms. Seven recommend strict maternal cow's milk exclusion for managing common symptoms in breastfed infants. We found CMA proven by food challenge affects approximately 1% of infants, while troublesome crying, vomiting, or rashes are each reported in 15% to 20% of infants. We found clinical trials do not provide consistent support for using maternal or infant cow's milk exclusion to manage common symptoms in infants without proven CMA. We estimated that for more than 99% infants with proven CMA, the breastmilk of a cow's milk-consuming woman contains insufficient milk allergen ...

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“Omics” and Biomedical Applications

Ferranti

Nitride

Gallo

2015

Analytical Separation Science

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Extensive research has shown that data generated by the various omic technologies represent a unique resource for biologists. This chapter explores how classical approaches to study biological processes, such as those used in chemistry, biochemistry, immunology, and genetics, intersect with the new omics technologies to advance the understanding of biological systems by examination of case studies of general interest for researchers. It explores the development of simple and robust methods for understanding the meaning of omics data in biomedical sciences. The chapter highlights that instead of looking at one potential biomarker at a time, the new techniques in genomics, transcriptomics, proteomics, metabolomics, lipidomics, and glycomics have allowed researchers to identify patterns in the changes of many genes and compounds that correlate with disease state. Mass spectrometry (MS) and spectroscopic techniques are the key analytical platforms on which the emerging omics technologies are based

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BSACI guideline for the diagnosis and management of cow's milk allergy

Cited by 316 publications

References 166 publications

Cow’s milk allergy

Cow’s milk allergy

Assessment of Evidence About Common Infant Symptoms and Cow’s Milk Allergy

“Omics” and Biomedical Applications

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