Emerald Group Publishing Limited
Copyright © 2008, Emerald Group Publishing Limited
Cows' milk allergy in infants
Article Type: Food facts From: Nutrition
The new European guidelines on the diagnosis and management of cows' milk protein allergy (CMPA) in breast and bottle-fed infants have been published in the October edition of the Archives of Diseases in Childhood. The authors of the new guidelines, the Act Against Allergy Taskforce, argue that the two algorithms, one for breast-fed infants and the other for bottle-fed infants, will lead to a more accurate diagnosis of CMPA. This will reduce the number of infants on inappropriate elimination diets, reassure parents and decrease the risk of impaired growth. The guidelines recommend the use of extensively hydrolysed infant milks (eHFs) for bottle-fed infants with mild to moderate CMPA. Until now, there have been no guidelines that specifically assist primary care physicians and GPs in the accurate diagnosis and management of the condition. Cow & Gate Pepti is the only extensively hydrolysed whey protein formula available for infants with mild to moderate CMPA.
CMPA is an adverse immune response to the proteins in milk. Symptoms of CMPA include skin rash, wheezing, vomiting, diarrhoea, constipation and distress. Milk is the most common cause of food allergy affecting 2-7.5 per cent of infants internationally. Symptoms suggestive of CMPA may be present in up to 15 per cent of infants which highlights the importance of ensuring that healthcare professionals know how to recognise the symptoms and diagnose this condition.
The protocol for bottle-fed infants defines a clear role for the use of extensively hydrolysed formulas (eHFs) in helping to diagnose and manage mild-moderate CMPA. How successful will the European guidelines be in forming a new consensus among UK healthcare professionals?
How will UK healthcare professionals especially GPs and dietitians integrate and adapt the European Guidelines to ensure their impact is maximised in the UK primary healthcare system?
The taskforce did not recommend soya-based milk for the algorithms as they considered that the risk that the child will develop soy allergy in addition to CMPA particularly below six months of age would outweigh the benefits. Will soya-based anti-allergy milks have any role in the future?
Perspectives we hope to offer the following perspectives:
Primary care perspective. A healthcare professional working in primary care will take a practical "coal face" perspective of how the guidelines will be implemented on the ground, what the challenges will be and how/if the guidelines will be useful.
Key opinion leader perspective. This will explain how the algorithms work, their impact on treatment options and what the prospects are for reaching a professional consensus in the UK on treating CMPA.
eHF manufacturer perspective. Dr Natasha Bye (Head of Scientific Affairs) at Nutricia/Cow & Gate. They view the guidelines as an excellent starting point in helping to achieve a professional consensus in the UK. They will outline how the eHF milks can play an important role in tackling CMPA and emphasise that UK professionals need to review the protocol and adapt it as appropriate into their practice.